Our chronicles relate the stories of elderly, G-d-fearing
Jews seeking to spend the remaining years of their lives in
the physically primitive but spiritually enriching atmosphere
of the Holy Land. After months of bumping in coaches and
wagons on the dusty, rocky highways of Europe, and days spent
seasick on the rolling, turbulent sea, these stoic pilgrims
finally were able to take their first hesitant steps on the
parched land of old Palestine.

An exhausting donkey-ride of a day or even two on a tortuous
road into the Judean mountains brought them in view of the
walls of Jerusalem. If they and their few possessions were
lucky enough to escape the notice of marauding Bedouins and
Arab chieftains, they finally experienced the thrill of
walking into the Jaffa Gate and entering the walls of
Jerusalem.

Once here, they joined the local Jewish community, which was
a conglomeration of Jewish repatriates from the four corners
of the earth. They spent and ended their days serving Hashem
and mourning the Temple's destruction near its last remaining
remnant. The small, damp, crowded apartments, and the
frequent mad frenzies and demands of Arab governors, intruded
in this idyll. But they were unfazed, serene in the knowledge
that they were the lucky few fortunate enough to fulfill the
dream that rested in the bosom of their Jewish brothers all
over the world.

Those of today's religious retirees who move to Israel hardly
have to undergo such severe initiation rites, yet most Jewish
retirees are still reluctant to spend the evening of their
lives in Israel. Many fear a seemingly insurmountable hurdle
of worries and adaptation pains without realizing that these
fears are less relevant today than ever before, while
conversely the benefits are far greater.

This is true even today, when almost every day one hears
disquieting reports of shooting and bomb attacks in Israel
from the north to the south. Many retirees believe that
instead of being the heartwarming land of our fathers, Israel
is beginning to sound like a scene out of a South American
guerrilla war movie. So how can they even consider moving to
Israel for their retirement during these uncertain times?

Yet, all the retirees from abroad interviewed for this
article were so positive about the move they had made that
not one said they would consider moving back or regretted
their decision in any way.

What makes Israel such an attractive retirement spot for
religious retirees from abroad? With what do retirees occupy
themselves? How do they manage financially? What kind of
medical health-care do they get? Why did they decide to move
to Israel, how did they prepare for their aliya, and what
aspects of Israeli life do they find particularly
problematic?

All this and more in the series of articles before us.

Israel's Growing Senior Population

Israel has one of the highest life-expectancy rates in the
world. The number of elderly (65+) in Israel has grown at an
unparalleled rate, increasing sevenfold since 1955 -- twice
the rate of the general population. At the end of 1999, the
elderly (65+) formed 11 percent of the Jewish population,
totaling 608,000, of which 132,000 were 80+. And the number
of the elderly is expected to rise continually, reaching
723,000 in 2010 and 1,026,000 in 2020, even outpacing the
increase in the general population sector.

Shemtov Benjo, the director of the Department for the Elderly
in the Jerusalem Municipality, says that according to
Ministry of Absorption statistics, 2,100 elderly made aliya
to Jerusalem from Europe and the U.S. in the past 5 years, of
which 630 were religious.

Commensurate with the growth of this sector, Israel has seen
accelerated development of services for the elderly. The
Israeli government -- aided by such nonprofit organizations
as the Joint Distribution Committee's Eshel (Association for
the Planning and Development of Services for the Aged in
Israel) and the Brookdale Institute of Gerontology and Human
Development -- has developed a large array of services for
the elderly, which cater to the different categories among
them.

Israel is thus a haven for the elderly, and it has a fully-
developed and comprehensive system of care and services
catering to their needs.

Financial Benefits Israel Gives All
Seniors

The State has passed two laws which have granted important
benefits to the elderly. These two laws also apply
conditionally to retirees from abroad who make aliya and move
to Israel.

In 1995 the National Health Insurance Law went into effect,
guaranteeing medical coverage by one of Israel's HMOs
(kupot cholim) to all of Israel's residents. The
importance of this law for the elderly is simply because they
use health services more than any other segment of society,
more than double the rate among the general population. Their
rate of hospitalization is three times higher.

The second law especially relevant to the elderly is the
Community Long-Term Care Insurance Law, which was passed in
1988. This law guarantees long-term care to the chronically
ill or disabled in the framework of day care centers,
supportive communities, old age homes, hospitals for the
chronically ill and sheltered housing.

We will explain this in more depth later in the article, but
the main point to remember here is that any senior who moves
to Israel will be eligible to receive complete medical care,
including living in nursing and senior citizens' homes. If he
has his own funds he or she will have to pay for these
services, but if not s/he will get them free.

Before these laws were passed, retirees from abroad over the
age of 60 who moved to Israel were not eligible for medical
services or a pension. A retiree who moved here had to have
his own medical insurance from abroad -- which often would
not continue to cover him if he left his native country -- or
had to pay for private medical insurance in Israel which for
retirement age individuals, was exorbitant. He had to have
sufficient private funds to cover possible hospitalization
costs or expensive operations and treatments. This alone
inhibited many from coming.

Today, this is no longer true. The law today provides the
same medical benefits to a retirement age oleh as it does to
Israeli citizens who have lived here their entire lives.
While some may have to pay for these medical benefits, the
cost is far less than private insurance in the U.S.

Lower Cost Of Living

Less crucial than medical expenses but also of great concern
to most retirees is the general cost of living in Israel,
since most are living on limited pensions. Many view Israel
as prohibitively expensive. However, new housing developments
in recent years have provided low-cost alternatives for many
retirees. As we shall see, whereas to live comfortably in
Jerusalem requires $20-30,000 a year, those willing to settle
in newer areas like Beitar Ilit and Kiryat Sefer can live
comfortably on $10-15,000.

Once medical care and cost of living are no longer an
obstacle, many retirees quickly come to the conclusion that
there are many benefits to living in a religious town or
neighborhood in Israel.

To write this article, we interviewed a dozen retirees from
both the U.S. and Europe from widely divergent backgrounds.
Their views represent a wide spectrum of experiences that a
potential retiree can expect to experience himself if he or
she (or they) decides to move to Israel.

Why Did They Come? Profiles Of Retirees From
Abroad

The vast majority of religious retirees who move to Israel
had visited Israel before. Most had come to visit children
who were learning or living here, while to others, Israel had
beckoned to them because it was the "Land of Our Fathers."

A significant number had intense memories of the Holocaust
and the hatred of Jews which had surfaced then, and felt that
the only place a Jew can really call home is Eretz Yisroel.
Other retirees were less ideological and stated plainly that
they didn't want to live among non-Jews anymore and loved the
intense Jewish life and atmosphere in religious neighborhoods
in Israel.

Saul and Chana Citron are both Holocaust refugees who spent
time in displacement camps before moving on to the U.S. where
they met, married and settled in the New York area. Both
remember avidly studying Hebrew in the DP camp in preparation
for moving to Israel but, as Saul explains it, "When I saw
the Hashomer Hatza'ir officials visiting the displacement
camps to recruit immigrants, I realized that Israel would be
built around the wrong lines and decided to go to the U.S.
instead."

During the decades after the war, the Citrons were occupied
with making a living in the jewelry business and raising
their three children. But Israel was sitting in storage in
Saul's mind, just waiting for the moment when he retired and
could fulfill his dream. His viewpoint was fueled by the
stark realization of many Holocaust refugees that, "What else
do the goyim have to do to us, for us to understand
that we have to go to Israel?"

The Citrons' first visit to Israel was in 1972. Chana didn't
know what to make of it when, on the second day of their
trip, Saul was already dragging her around to see real estate
agents. When Saul almost signed on a contract for an
apartment, Chana burst out weeping, sensing that they were
about to sign away their lives for a drastic change. Instead
of touring the country during that visit, Saul toured with
Chana from one real estate broker to the next. However, the
short visit didn't result in finding the Israeli apartment
that Saul had dreamed of.

Only when Saul visited Israel several years later by himself,
did he finally sign on an apartment in Bayit Vegan.

Saul's dream moved into high gear. All of their extended
family lived in the U.S., and all three of their children
lived within several blocks of them -- but Saul was
nonetheless determined to live in Israel. Before Saul retired
the couple spent one month each year in Israel, and when
their son decided to make aliya in 1987, that finally
convinced the Citrons to move for good. Their friends in
their chassidic shul in Boro Park gave them a warm
farewell, convinced that they were crazy.

Rabbi and Mrs. M. S. from London had visited
Israel five times before. Over the years, ten of their 16
children moved to Israel and they were living in Bnei Brak,
Ashdod, Emanuel and Jerusalem. The S.'s knew they wanted to
settle in Israel for their retirement, but they waited until
Rabbi S. turned 65 and was eligible for a pension.

Mrs. S. says, "We would have come here even if we had no
children. Just living among Jews and not having to deal with
non-Jews in daily life is a tremendous advantage."

Max Carmen, from Detroit, prepared his Israeli
home three decades ago, when his son was studying in the Mir
Yeshiva and told him he wanted to settle in Israel for good.
In 1972 he decided to buy an apartment in the new
neighborhood of Arzei Habira which was just being built,
assuming it would eventually be used either by him or his
son. His son returned to the States, married, and then came
back after his fourth child was born, but Max didn't retire
and come until his own mother passed away (at age 101).

"We had enough of America," he says simply. "We have 7
children and loads of grandchildren living abroad, and only
one son and his children here. But we would have come even if
we had no children."

Rabbi Avrohom Gross was the rov of a shul
in Washington Heights and the chaplain at Columbia
Presbyterian Hospital in New York. He had visited Israel
numerous times before making aliya at his retirement.

The Grosses too say they would have moved to Israel for
retirement even without children here. (Although they do have
married children living in Jerusalem, most of their children
still live abroad.)

In their case, they had a solid family tradition of spending
one's last years in Israel, since both sets of their parents
came to Israel as soon as they reached retirement. The
Grosses had always felt that living in Israel means achieving
a more spiritual life, dwelling on holy land, living among
one's own people and feeling closer to Hashem.

Since the Grosses knew they would settle in Israel, they
bought an apartment seven years ago in Mattersdorf, but on a
consecutive visit decided the advantages of living closer to
town justified exchanging that for an apartment in Geula.

Rabbi and Mrs. K. had come to Jerusalem from
northern England to care for a sick, elderly mother. The
couple were anyway at retirement age when they decided to
give up their jobs to help their elderly mother out. After
she passed away, they decided to stay. "We hadn't thought of
moving here," says Mrs. K. "But if Hashem brought us, we'll
stay."

The R.'s had become religious after their son
became religious during a visit to Israel. When their son
married and settled in Israel for good and Mr. R. turned 62
and approached retirement age, he and his wife decided to
settle in Israel to be near their son.

Two couples which the Yated interviewed
moved to Israel despite not having support from family or
previous acquaintances to ease their move to Israel.

The H.'s had always dreamed of moving to Israel. Says Mrs. H,
"There were always reasons why we couldn't do it --
parnossa, parents, children, it was always something.
Finally, all of our children were married and we only had one
son left at home who had finished high school and was ready
for beis midrash. We hoped that this son would come to
study in Israel and settle down in Israel like us for good,
but after a short time learning here he decided to go back,
marry and live in the U.S. like his siblings.

"We decided to move to Israel because we felt our future was
here. Once our children didn't need us, we still wanted to
accomplish for ourselves. We felt that Jerusalem was an
important step that would impact on our lives.

"We were both born before the State was founded. When I was
young, Eretz Yisroel was a dream. I remember looking up the
Wailing Wall in the encyclopedia, just to see the picture of
Jews crying next to it. I told myself in awe, `It really
exists.' I would stare at the picture and dream of it. Our
parents and us dreamed of going to the Kosel and davening.
When I grew up, I realized that the possibility of going
there was real. We can touch the Kosel, live in Jerusalem and
shteig here . . .

"After we moved here, we'd look at the Harei Efraim from our
house and tell each other, `If only our parents could be
here, to shep nachas from where they are in the
Olom Ho'emes to see that we're here. They lived
through the Holocaust and other discouraging times, and now
here we are, their children, living in Eretz Hakodesh.' We
were sad that our kids didn't want to come but we decided
that we could either remain there and watch our children
shteiging, or we could shteig ourselves."

The F.'s were not blessed with children, so
this was never a component in their equation of where to
live. Mrs. F. said she always dreamed of moving to Israel
since her first trip in 1977. She remembers walking out of
Yad Vashem and feeling a burst of energy to devote herself to
"my country." Practically, the F.'s made aliya when Mr. F.
reached retirement at 65 in 1992, and Mrs. F. was still in
her 50s.

Everyone quotes: "Eretz Yisroel is acquired through
suffering," but the experiences of most retirees tended to be
fairly positive. From the spiritual point of view, the
retirees were effusive in their description of the many
opportunities that living in Eretz Yisroel has to offer. Most
spoke with satisfaction concerning the standard of living and
medical services. Still, everyone had a few items of life in
Israel that regularly annoys them.

As Rivka Benari of the Association of Americans and Canadians
in Israel (AACI) says, "People who make aliya and move into a
religious environment are befriended and cared for. They
don't feel alone. Every religious community has a
tzedokoh, chesed, or welcome group and the religious
world is known for its tremendous outreach. I find that they
take care of their own, whether they need loans, clothing, or
anything else. They also have an endless amount of
activities."

Medical Care For Seniors In Israel

According to the National Health Law in effect since 1995,
every Israeli, including an oleh, is eligible to receive
medical care. That law in effect nationalized the health care
system, putting the collection of all payments into the hands
of the Bituach Leumi (the National Insurance Institute that
handles the state pensions, like Social Security in the
U.S.). Before that the Sick Funds (similar to HMOs in the
U.S.) were independent and set their own conditions for
joining, and it was difficult for an older person newly
arrived to join. Now, collections are through the Bituach
Leumi, payments to the HMOs are direct from the government,
and people join separately, choosing whichever one they
want.

There are four HMOs, which remain nominally independent:
Clalit, Maccabi, Leumi and Meuchedet. There is a basic
"basket" of government-mandated health services that all must
offer, but there are differences between them. In a
particular area there may also be variations, for example, an
outstanding doctor.

Israel's elderly are members of the HMOs according to this
distribution: 75 percent are members of Clalit, 13 percent
are in Maccabi, 7 percent Leumi, and 5 percent in Meuchedet.
Most elderly olim end up in Clalit because it is the only HMO
that will take them. Before the Health Law it was impossible
to get into any other HMO. Now it is only difficult. All the
HMOs offer full medical services, lab tests, etc.

The retirees we spoke with expressed the full spectrum of
responses concerning how they evaluated Israel's medicine. We
heard everything from "Medical care is awful" to "Medical
care is very good."

The impression Yated received after speaking with ten
different retirees is that it is easy to enroll in a HMO, and
the service one gets is acceptable and even good. However,
the quality of medical care one receives depends to a large
degree if the member had made it his business to find the
best doctors, and secondly, how far away one lives from a
clinic or from where a good doctor lives. Some retirees
reported they had to travel far to obtain medical care,
because each doctor has his own office in a different
location, the lab is in the Kupah's center, etc. Although
anyone who lives in Jerusalem is just an inexpensive and
short taxi or bus ride away from any doctor's office, if one
needs daily medical care it can add up.

One retiree emphasizes that Kupat Cholim is a very different
system from that in the U.S. In many cases, the doctor
doesn't know the patient well, doesn't have much time to
check him, and doesn't automatically do a comprehensive
checkup including such a basic as taking blood pressure. Many
times, there are no nurses or receptionists to receive a
person. She concludes, "We use the Kupat Cholim, but we've
learned you have to be knowledgeable, know what you're doing,
know how to talk with the doctor, and know how to choose
doctors and specialists."

Mrs. G. agrees emphatically, "My father-in-law had better
medical care here than my father received in the US. Today
you have a choice of the best doctors. There are many top
Anglo-Saxon doctors available in each Kupah. AACI advised my
father-in-law to join Clalit, and anything he needed to have
done, we were able to get done there. We did our homework on
good doctors. We had friends who were doctors and helped us
connect with the best. Most of his medical expenses were
covered by the Kupah so that only on a rare occasion did he
have to see someone privately."

Mrs. G. added that the medical care is accompanied by a care
and concern that she thinks is found only rarely abroad. "My
father was niftar in what was supposed to be the best
nursing home in his town in the U.S. But I felt it was a
disgrace how he was treated at the end. Here, everyone cares
about a sick parent as if it was their own parent. My father-
in-law was treated with tremendous care and concern by the
hospital staff and the doctors alike. That's how it's like in
Israel -- if you put a child on a bus, or if a child slips on
the street, you know the people around him will look after
him if anything happens."

Max stresses that medical care is low cost. Retirees in the
U.S. who have Medicaid still need to supplement it with Blue
Cross-Blue Shield, which costs thousands of dollars more. He
says that other than paying a little more for the Kupot
Cholim's upgraded health insurance plans (like Zahav and
Adif) which give you better medical care for an additional
low sum, one doesn't need private insurance. He says that he
goes to U.S. doctors in Jerusalem who are very good.

An Oleh with a Terminal Illness

Mrs. Benari mentions an astonishing story with which she was
personally involved. Although she has dealt with several
cases of terminally ill people who decided to make aliya
because they wanted to die in Israel, one particularly stands
out in her mind.

A wealthy childless Holocaust survivor who was very sick,
decided he wanted to end his life in Israel. He carried out
the aliya process before he arrived, including joining Kupat
Cholim Clalit. By the time he had arrived in Israel, he had
to be taken straight to a hospice, which was paid for by
Kupat Cholim Clalit funds. The man had willed his fortune to
various charities in Israel but according to law, Clalit had
to pay for his stay in the hospice. His burial was also free
of charge.

A Bad Story

A hospital error can (and does) happen anywhere, but this
story shows what can happen when one hasn't learned how to
navigate the Kupat Cholim system properly. This happened to a
couple who made aliya without children here and who had to
figure out the system themselves.

The husband became ill the second year they were in Israel.
He kept getting sicker and sicker, until finally the couple
thought they found out what he had. He was prescribed
medication by a Kupat Cholim doctor, but he continued to be
ill. The Kupat Cholim doctor gave him another medication but
this medication caused him to be even sicker.

The husband became seriously sick before a doctor finally
discovered what was happening to him. It turned out that each
medication was just treating side effects caused by the
previous medication. The couple went back to the States and
had a top-grade doctor treat the husband there. The husband
was taken off all medications, and in the end, discovered he
didn't need almost any of them.

Nursing, Convalescent, and Elderly
Services

Although most Anglo-Saxon retirees usually associate with
each other instead of blending in with the general Israeli
populace, it's important to know that Israel offers a wide
range of social, medical and nursing services for the general
elderly population. They may find these services particularly
helpful especially if they are living alone, are
incapacitated and handicapped, or mentally frail.

The Services for the Elderly (Tel. (02) 6298002/3) offered by
the Jerusalem municipality are many and varied. Mr. Shemtov
Benjo, the department head, says that according to statistics
which he possesses, about 2,100 retirees moved to Jerusalem
in the past five years, 630 of whom are religious. (The other
1,470 came to fulfill the Zionist dream, escape antisemitism
or economic problems, to join their children, or because they
were abandoned by their families abroad and couldn't function
independently.) Of these 2,100 senior olim, 441 needed the
city's welfare services.

Mr. Benjo says that when assessing an ailing senior oleh's
needs, the municipality always asks if there is someone local
who can take responsibility for him. If the elderly oleh has
no one, the State will still accept him. In several cases
elderly olim came to Israel and were immediately placed in a
seniors' home. "There is no such thing as an elderly person
coming to Israel who is not cared for," Mr. Benjo says
emphatically.

Here is a partial list of municipal services available for
seniors in Jerusalem:

1) Community centers in Romema, Har Nof, Ramot and Bucharim
neighborhoods run clubs where elderly people can meet,
participate in enjoyable activities, socialize with each
other, and sometimes receive a warm meal.

2) 25 Information, Referral and Placement Centers operate
throughout the city, including in Bucharim, Beis Yisroel, Har
Nof, and Meah Shearim. Their aim is to provide up-to- date
information about old age residences, day centers for the
physically disabled, respite care, services for the
cognitively impaired and meals on wheels services.

3) Referral and placement of the elderly in old age
residences, sheltered accommodations, respite and
convalescent residences, and day care centers for the
chronically ill and cognitively impaired.

4) Home care for the elderly who are tied down to their
homes. Each senior has a card, and is checked regularly by
volunteers. (Many chutznik volunteers help out in this
program.)

5) Eight "supportive neighborhoods" including one located in
Meah Shearim and Bucharim. This service, which is run by
Misgav LeKashish, helps the elderly who are at least 75
percent handicapped. Those signed up for this program get a
basket of benefits including an emergency device which
remains in reach so they can press it whenever they need. The
center immediately answers all calls. A housefather is
appointed over each group to insure their needs are met. The
advantage of this program is that it allows a handicapped
senior to remain at home instead of moving him out to an old
age home.

6) Elderly Protection -- to protect those who suffer from
abuse or neglect.

7) Nachshon Convalescent Home -- for seniors who need a short
vacation after an operation, or for families caring full-time
for an elderly parent who need a place for him to stay if
they need a short vacation. The Convalescent Home has place
for 31 people and is kosher mehadrin. (Most food
services provided by the Jerusalem municipality for the
elderly are kosher lemehadrin, in keeping with the
large percentage of religious living in the capital.)

8) Day centers for the severely handicapped -- running from 8
to 2, the day centers provide medical services daily to the
severely handicapped. They are transported to centers to
receive physical therapy, are served a meal, helped with
grooming, given attention, and then are returned home. There
are additionally five day centers that service 450 senile,
Alzheimer's patients, etc. which also are open in the
afternoon. The Levav clubs sponsored by the city specifically
target Alzheimer's patients.

9) The Community Long-Term Care Insurance Law insures that
people who are unable to take care of themselves and their
home receive the daily services of a helper who cooks food
for them, cleans their home, helps them with grooming, etc.
The Jerusalem municipality has 6,000 people who receive this
service, and the Services for the Elderly department checks
up after them to make sure they do their work properly.

10) Public protected housing for the independent elderly who
can live by themselves but need some help. Each housing unit
is run by a housemother who helps the elderly in whatever
they need. About 521 elderly make use of this service. These
are similar to private retirement homes, but since they are
public, they don't have the same range of services and
standard of care. Each resident pays according to his
financial state, with the poor paying only a symbolic amount
(400-500 shekels a month instead of 5-6,000 shekels).

11) Occupational centers for the elderly ("Moadanei
ta'asuka"), a new project of the Jerusalem municipality.
There is one such large occupational center in Yad Sara's
Headquarters on Herzl Avenue, and the city is preparing two
more in the Diplomat Hotel including one for Russians, and
another one in East Talpiot. These enable the elderly to work
at a productive, fulfilling job at their pace and within the
range of their skills.

Eshel (Tel. (02)6557551)

One group that is avidly working at developing community and
institutional services, health promotion and prevention of
illness for the elderly is Eshel, the Association for the
Planning and Development of Services for the Aged in Israel,
which is partially funded by the Joint Distribution Committee
and the Brookdale Institute of Gerontology and Human
Development. It is a secular organization that engages in
activities like social work and medical support.

They publish much printed and electronic material concerning
the elderly in Hebrew, English, and Russian, and also offer a
range of their own services, such as bringing medications to
those who can't get it themselves, ambulance services, etc.
They have a website which features a large database of
services all over Israel for the elderly
(www.eshelinfo.org.il) which I found less unnavigable than
promised. The English version is:
www.jointnet.org.il/eshelnet/english/index_eng.html

Retirement Homes

No matter what your financial condition, a senior who is in
need of an old age home will be placed in one by Israeli
law.

A public old age home I briefly spoke with on Yam Suf Road in
Sanhedria Murchevet said that it has 200 beds and is always
full. The Welfare and Health Services decide if a senior
citizen needs to be transferred to it and they pay the cost.
(If the resident has financial resources, he must pay for it
according to his means.) That home services all kinds of Jews
including Western and Eastern European, army veterans,
Ethiopians, and more.

Most retirees from abroad would not be comfortable moving
into such a home and there are in fact very few English
speakers living there. However, Jerusalem does have a number
of private retirement homes which do contain a large number
of retirees from abroad.

Two which we superficially looked over are Beit Tuvei Ha'Ir
(Tel. (02)5318491) in Geula (the Concord Hotel), and Neve
Simcha (Tel. 5008111) in Mattersdorf, both of which have a
large percentage of their residents from abroad. Two other
centrally located ones are the Tamir Hotel (Tel. 5724444) on
Ramot Road and Shomrei Hachomos (5890333) in Sanhedria
Murchevet. A well-known one in Bnei Brak is Beit Abba Ve'ima
(Tel. (03)5788088). These are all private retirement homes
which offer a comfortable suite to live in and provide a
range of social and medical services. Many of the residents
are not in the least incapacitated but prefer to move to
retirement homes because of the convenience -- their
residences are maintained, food is provided, and services are
at their fingertips. In most cases the residents are single
women, although there are some couples who prefer this
arrangement. Residents' children visit on Shabbos and the
residents can socialize with the other residents instead of
living alone and being lonely.

Ms. Evelyn Paluch, who is the social coordinator at Tuvei
Ha'Ir, says that at the present, they have religious retirees
from the U.S., England, Holland, South Africa, Israel,
Switzerland and Austria. The retirement home has room for
145, and offers one to 2-1/2 room suites, each with its own
kitchen, bathroom and balcony. The program for seniors
includes: gemora, parshas hashavua, Tehillim Club,
Pirkei Ovos, gymnastics, swimming (in their own
swimming pool), music lessons, and for the ladies: folk
dancing, choir, and aerobics swimming. Newspapers and
haircuts are provided for those who request them.

Seniors who don't live in the retirement home are welcome to
hear the guest speakers and take part in activities every
Shabbos. They have a Cultural Club which features first rate
speakers every month including Chief Rabbi Lau, the Chief of
Police, a musical program, and a "Moadon Chodesh Tov"
(Hebrew).

Once a week they run in English a "Fitness and Learning
Program" for women which includes aerobic exercises, a
shiur, and coffee and cake. The program was recently
expanded to 60 ladies in two groups. They also organize a
trip once a month to places such as Gilo, Holyland Hotel, and
the Kosel.

Mrs. Paluch describes the residents as ranging from 65 to
100. Most are ladies who are alone, but there are a few
couples and lone men. The retirement home offers around the
clock medical supervision by a nurse, and visits by a doctor
four times a week. Every room has an emergency button. Rooms
are cleaned twice a week. The retirement home also doubles as
a convalescent home for people from abroad who need to rest
after an operation, and who have children here.

Mrs. Paluch says, "If you're healthy, it's an active,
fascinating life. We have a very interesting mix of people
here." She says that the retirees who move in generally have
children or grandchildren in Israel, or a middle-aged couple
may be moving to Israel and they bring along an elderly
parent who they feel will be comfortable there. She says that
some of the lady residents love Jerusalem so much that they
came despite the fact that their children are living
abroad.

Neve Simcha is not only a retirement home, but also has a
wing which provides complete nursing facilities to those who
are totally dependent.

Rabbi Menachem Klein, the director of Neve Simcha says that,
in his experience, people who are sick prefer retirement and
convalescent homes, whereas healthy individuals prefer to
move into their own apartment. He explains that today there
are many services available to help the elderly manage at
home, so fewer and fewer people are leaving their homes for
institutions.

However, the loneliness and convenience of having all one's
needs provided for is what often convinces a person to join a
retirement home. A person's food is prepared for him daily. A
laundry service comes right to his room to pick up his
laundry. Repairs, medical care, and most everything else are
all arranged by phoning the reception. The only disadvantage
is that a person has to adapt himself to the retirement
home's schedule, such as eating during the hours when food is
served.

Mr. Klein says that "Residential Suites" which are
essentially private condos are becoming popular in retirement
homes. Neve Simcha built an entire new wing like this. Each
suite has two rooms with a kitchen, and the resident can
bring in his or her own furniture and live on the premises as
if it were his own apartment. There is a joint (self-service)
laundromat in the wing for the residents, and a supermarket
nearby where people can shop for their own food. The
residents of these suites also have the option to take
advantage of the retirement home's other services including
ordering food for Shabbos or weekdays, janitorial services,
and more.

The reason why people prefer these residential suites is to
maintain their independence and privacy. Neve Simcha also has
"convalescent rooms" where people recovering from operations
can stay.

For a retiree who is thinking of joining a retirement home in
Israel, Mr. Klein recommends registering as an oleh abroad
and arriving with membership in a Kupat Cholim already
confirmed. Otherwise, if he needs medical service, it might
cost a fortune. The retirement home needs to have detailed
information about each resident's state of health in case an
emergency arises and they have to deal with it.

He explains that the retirement home insists that every
senior citizen who moves in must have a guarantor for him who
lives in Israel to sign and, if necessary, approve treatments
or operations he may need, and to commit himself to
unexpected financial expenses if these arise.

"We had a case where one of our retirees suddenly needed full-
time nursing care," explains Rabbi Klein. "We got in touch
with the man's relative abroad and he told me that he refused
to be responsible for it. In the meantime, we'd incurred more
than $140,000 in uncovered medical expenses for him. If there
is a guarantor in Israel, we can get hold of him much more
easily."

He explains that Israel has a law (Chok Mezonos) which
stipulates that if a father is sick, the children have to pay
for his old age home, just like parents have to pay for their
children's treatments. A child who doesn't want to pay for
his father's needs can be forced to do so by law. But if the
children are abroad, the nursing homes have no legal
leverage.

Rabbi Klein says that before the government will authorize
putting an elderly person in an old age or nursing home, they
demand a contact person who will take responsibility for the
invalid. If the elderly person doesn't have anyone who can be
his or her guarantor, the government will not abandon him but
it won't automatically pay for him either. They will check
his financial state and may confiscate his Social Security
check, his bank savings, and any other possessions he has to
pay for the level of nursing care he needs. The State is very
strict about each person paying for the services he gets if
he has the means.

In Neve Simcha, 20-25 percent of the residents are from
abroad.

Retirement Payment Schemes

All the private retirement homes have an interesting payment
scheme which they offer retirees. Rabbi Klein explains that
in Neve Simcha for example, retirees are asked to deposit
with the institution $120,000 or $150,000, depending on the
size of the room or suite. This sum remains his, but 2-3
percent of it is depreciated every year from it. The result
is that he pays NIS 3-4,000 every month (about $7-900).

For this reasonable sum, he gets the full services of the
retirement home -- utilities, cleaning, repairs, taxes,
medical services, mikveh, social activities, and more.
Food is separate. If the resident passes away or decides to
move out, s/he or his heirs receive whatever remains of the
deposit.

Alternatively, s/he can pay NIS 7,500-9,000 ($1750-2100) a
month rent for the same services, depending on what standard
of services he needs, including food. A full-time nursing
suite costs NIS 11,000 ($2600). Convalescent rooms cost NIS
390 ($92) a day per person, and NIS 600 ($141) per couple.
(Exact costs are subject to change and should be checked with
the retirement home.)

The costs in the various homes vary, but they are basically
similar all over. The amounts compare favorably with similar
facilities in the U.S. and in some cases are way below what a
similar level of services costs -- and these are in
Yerushalayim.